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Objectives Preconceptional health care is increasingly recognized as important to promotion of healthy birth outcomes. Preconceptional care offers an opportunity to influence pregnancy timing and intent and mother's health status prior to conception, all predictors of individual outcomes and of inequality in birth outcomes based on race, ethnicity and class. Methods One Key Question, a promising practice developed in Oregon which is now attracting national interest, provides an entry point into preconceptional care by calling on providers to screen for pregnancy intent in well woman and chronic disease care for women of reproductive age. For women who choose not to become pregnant or are not definitive in their pregnancy intent, One Key Question provides an opportunity for provision of or referral to counseling and contraceptive care. Results Adoption of One Key Question and preconceptional care as standard practices will require important shifts in medical practice challenging the longstanding schism between well woman care generally and reproductive care in particular. Adoption will also require shifts in cultural norms which define the onset of pregnancy as the appropriate starting point for attention to infant health. Conclusions for Practice This commentary reviews the case for preconceptional care, presents the rationale for One Key Question as a strategy for linking primary care to preconceptional and/or contraceptive care for women, outlines what is entailed in implementation of One Key Question in a health care setting, and suggests ways to build community support for preconceptional health.

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The purpose of this study was to gain an in-depth understanding of how primary care practices in the United States are transforming their practice to deliver patient-centered care. The study used qualitative research methods to conduct case studies of small primary care practices in the state of Virginia. The research team collected data from practices using in-depth interviews, structured telephone questionnaires, observation, and document review. Team-based care stood out as the most critical method used to successfully transform practices to provide patient-centered care. This article presents 3 team-based care models that were utilized by the practices in this study.

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The organizational practices used to ensure adolescent family planning confidentiality in FQHCs are varied across organizations.

Yakima County, Washington was subject to the extrordinary Washington Wildfire Season of 2020 in which unhealty air (PM2.5) persisted for a 14-day period. This remarkable fire and smoke season began in tandem with the COVID-19 pandemic. SARS-CoV-2 virus, like inhaled particulate matter is known to cause respiratory illness or injury. This study sought to determine through publicly available data whether increased levels of PM2.5 were associated with increased cases of COVID-19. Using a 12-day lag analysis, Pearson product correlations were performed between PM2.5 24-hour averages in Yakima County Washington and daily confirmed cases of COVID-19 for data available on March 1, 2020-October 15, 2020. In addition, total running cases of confirmed COVID-19, daily mortality and total running mortality rates were compared in the lag analyses. All days (PM2.5) in the lag analysis were found to have a statistically significant positive correlation with COVID-19 case counts and total running counts of COVID-19 (p<.001) with correlation coefficients ranging from 0.24-0.28. The total running mortality rates were also significantly associated with daily PM2.5 (p<.001); however, the daily mortality rates were not found to be statistically significantly related to PM2.5. This simple analysis provides preliminary evidence that increased air pollution (PM2.5) is associated with higher rates of confirmed COVID-19 cases. However, further research is required to determine the potentially confounding factors in this relationship.

Despite community health centers' substantial role in local communities and in the broader safety-net healthcare system, very limited research has been conducted on community health center research experience, infrastructure, or needs from a national perspective. A national survey of 386 community health centers was conducted in 2011 and 2012 to assess research engagement among community health centers and their perceived needs, barriers, challenges, and facilitators with respect to their involvement in public health and health services research. This paper analyzes the differences between health centers that currently conduct or participate in research and health centers that have no prior research experience to determine whether prior research experience is indicative of different perceived challenges and research needs in community health center settings.